What the GOP repeal plan means for 650,000 Michiganders

Right now, the Medicaid expansion is a pretty sweet deal for Michigan and the 650,000 people covered under it.

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If you're trying to understand what the heck this new Republican health care bill would mean for you, you’re not alone.

Let’s do a quick recap: Medicaid is health insurance for really low income people. Under the Affordable Care Act, states including Michigan expanded their Medicaid programs. Suddenly single adults making $16,600 a year were eligible, or a family of four making about $34,000 a year.

Since then, 650,000 Michiganders have signed up for that Medicaid expansion, called “Healthy Michigan.” Researchers say most of those people didn’t have insurance before this.

And it’s a pretty sweet deal for Michigan, because right now, the federal government is picking up most of the tab.

Under this new proposal, however, things would change. The federal government would say to Michigan and other states: Here’s a flat amount of money, based on how many people are on your Medicaid rolls right now.

“And if you spend more, if you're a more expensive state than medical care inflation going up, then, state, you have to make that up from state dollars,” says Marianne Udow-Phillips, the executive director of the Center for Healthcare Research and Transformation at the University of Michigan.

Basically, if the cost of healthcare goes way up, then Michigan will be left with the bill.

"The state would probably have to make up for much more funding, when new innovations, new drugs come on the market that weren't accounted for, that didn't happen in 2016,” she says.

That could mean that, down the road, states like Michigan may kick people back off Medicaid.

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There’s a young couple in Washtenaw County trying to get off heroin. They say so far, they’re doing great. After 22 months in treatment, she’s going to community college and he says he’s working at a high-end grocery store.

They’re just two of the 20,000 low-income Michiganders who now have free access to drug treatment.

But because it’s tied up with the Affordable Care Act, nobody knows if it’s going to last.

The federal government has approved Michigan’s request to expand Medicaid eligibility in Flint.

The U.S. Department of Health and Human Services says pregnant women and people under 21 in Flint are now eligible for the expanded coverage.

The Snyder administration asked the federal government for the expanded Medicaid coverage, as part of its response to the Flint water crisis. There are concerns about the health effects of exposure to Flint’s lead-tainted drinking water.

Gov. Rick Snyder’s new budget contains over $100 million for Healthy Michigan.

That’s a reminder that it’s time for the state of Michigan to pony up some of the Medicaid expansion program’s operation cost. That Healthy Michigan program means health insurance for some 600,000 lower-income Michiganders.